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----------- <br /> ' AMERICAN <br /> ---' AMERICAN VALLEY v 93629 <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668880 <br /> EPA. CAL000827878 / <br /> BILL TO: CA TIRE JOB SITE:MANTECA TIRE Invoice Date: <br /> MANTE <br /> 201 W.CA 71 RE <br /> SON 201 W.EDISON <br /> MANTECA,CA 95336 MANTECA CA 95336 <br /> 4W K 01L <br /> Sales Rep: <br /> Phone Customer P.O. TerNss [Oat's EPAttCAL000010248 <br /> 209-239-3558 GREG <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty premixed Recycled Antifreeze <br /> Trinity Extended Life premixed Recycled Antifreeze <br /> Trinity Case Goods <br /> Truck Wash Out <br /> Truck Time <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> becomes necessary to collect this invoice, f <br /> that <br /> are <br /> ess than 1 <br /> RPM;and that the <br /> ste <br /> containiany P.C.6 s.I herby certify <br /> fiurtheertagreeenot to accept mixedthis <br /> Gadditional charges for legal diother sposal if thehe awaste is over 11000 P.P.M.total al halides,or contains aany P.C.gsot <br /> Generator's Certification: By signing I certify that I have a program in place to reduce the volume and toxicity of hazardous waste generated to the degree I <br /> have determined to be economically practicable. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the <br /> generator that their waste has been transported to a licensed treatment or transfer facility. <br /> American Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil may be transported to a facility that is required to comply <br /> with federal regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> waste management facilities.California facilities that handle or process used oil are required to meet those more stringent requirements, and some out-of- <br /> state facilities that process used oil also meet those requirements, engineering certifications of tank integrity, and financial assurances for closure and <br /> accidental releases. It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards an not these more <br /> stringent requirements. ( f <br /> This notification is forjai ation purposes only. <br /> DRIVER GENERATOR/AUTHORIZED ) <br /> SIGNATURE SIGNATURE SIGATURE r <br /> DISPOSAL / RECY LING FACILITY O NAME: <br /> ADDRESS: <br /> K-DIXON O RAMOS ENVIRONMENTAL SERVICE <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD CITY/ST: <br /> DIXON,CA 95620 W.SACRAMENTO,CA 95691 PHONE: <br /> 707-693-6008 916-371-5747 <br /> EPA#CAT080012602 EPA#CAD044003556 EPA#: <br /> MPC(iwr09) <br /> el,'d 9ZLL-6£Z-60Z IpueS ueA A069.10 869:60 OI 40 PO <br />